We also try to identify what causes poor person-centered care.
At the individual and interpersonal levels, drivers of poor person-centered maternity care include inadequate provider knowledge of and poor attitudes about person-centered care, power asymmetry between patients and providers, provider stress and burnout. This work has also highlighted provider bias as a key driver of the disparities in person-centered care.
Systemic and social drivers of poor person-centered maternity care include institutional and health system factors, lack of accountability and broader social and gender norms that facilitate and normalize disrespect and abuse.
Selected publications
- Afulani PA, Edwards AM, Buback L, Kirumbi L, Asunka A, Lyndon A. "Providers perceptions of disrespect and abuse care during childbirth: A mixed methods study in Kenya.” Health Policy Plan. 2020 Mar 10. PMID: 32154878.
- Afulani PA, Buback L, Kelly AM, Kirumbi L, Cohen CR, Lyndon A. Providers’ perceptions of communication and women’s autonomy during childbirth: a mixed methods study in Kenya. Reprod Health. 2020;17(1):85. doi:10.1186/s12978-020-0909-0
- Buback L, Kinyua J, Akinyi B, Walker D, Afulani PA. Provider perceptions of lack of supportive care during childbirth: A mixed methods study in Kenya. Health Care Women Int. 2021;0(0):1-22. doi:10.1080/07399332.2021.1961776
- Afulani PA, Ogolla BA, Oboke EN, Ongeri L, Weiss SJ, Lyndon A, Mendes WB. Understanding disparities in person-centred maternity care: the potential role of provider implicit and explicit bias. Health Policy and Planning. 2021;(czaa190). doi:10.1093/heapol/czaa190
- Afulani PA, Aborigo RA, Nutor JJ, Okiring J, Kuwolamo I, Ogolla BA, Oboke EN, Dorzie JBK, Odiase OJ, Steinauer J, Walker D. Self-reported provision of person-centred maternity care among providers in Kenya and Ghana: scale validation and examination of associated factors. BMJ Glob Health. BMJ Specialist Journals; 2021 Nov 1;6(12):e007415.
- Afulani PA, Okiring J, Aborigo RA, Nutor JJ, Kuwolamo I, Dorzie JBK, Semko S, Okonofua JA, Mendes WB. Provider implicit and explicit bias in person-centered maternity care: a cross-sectional study with maternity providers in Northern Ghana. BMC Health Services Research. 2023;23:254. doi: 10.1186/s12913-023-09261-6.